…the acromion and the lower tip of the muscle insertion. 3. Stretch the skin with the thumb and index finger, or compress the muscle in…

…pain and pain in the palliative phase. Severe breathlessness in the palliative phase (at lower doses than for pain). An opioid is rarely the right…

…80% of cases. Other causes include acute mechanical complications—particularly ventricular septal defect (VSD) and papillary muscle rupture with acute severe mitral regurgitation—predominant right…

…to BNP and NT proBNP in heart failure (HF). The biologically active natriuretic peptides promote vasodilation, renal sodium and water excretion, and reduction of cardiac…

…The first half of the P wave is therefore a reflection of right atrial activation and the second half is a reflection of left atrial…

…left ventricle is usually considerably larger than the right ventricle, the QRS complex is actually a reflection of the electrical potentials generated by the left…

…image of the tissue, the ultrasound machine must overcome the following technical obstacles. The ultrasound machine must know which sound waves are reflected and from…

…left ventricle is many times larger than the vector generated by the right ventricle, the QRS complex is actually a reflection of left ventricular depolarization…

Cardiology Introduction Since its initial description in 1992 as a syndrome of right bundle branch block, ST segment elevation, and sudden cardiac death (SCD), Brugada…

…venous outflow and persistent right sided congestion may be important mechanisms. Diuretics relieve the hemodynamic consequences of congestion by producing a negative sodium and water…

…malignant than anomalous origin of the right coronary artery. High risk anatomical features include: An interarterial course between the aorta and pulmonary artery A slit…

…The first half of the P wave is therefore a reflection of right atrial depolarization and the second half is a reflection of left atrial…

…thrombus is pumped from the right ventricle through the pulmonary valve into the main pulmonary artery. Depending on the size and form of the thrombus…

…paradoxus. Tamponade is therefore characterized haemodynamically by elevation and near equalization of diastolic pressures in the cardiac chambers, with chamber pressures approaching intrapericardial pressure. The…

…2. Sinus bradycardia, two premature ventricular contractions, incomplete right bundle branch block and ST segment depressions in V2 V6. Click to zoom. Figure 3. Sinus…

…a complication of rheumatic fever, which is caused by streptococcal infections (group A Streptococcus ). Rheumatic heart disease can occur at any age and multiple valve…

…Immobilisation after reduction of a dislocation. Immobilisation of a ligament injury, a tendon injury, or after suturing over a joint. Pain relief and stabilisation for…

…A history of a severe transfusion reaction: contact transfusion medicine before transfusing again. Preparation and equipment Compatibility testing Test What it involves When it is…

…vomiting, muscle cramps, apathy, confusion, impaired reflexes. Severe <115 mmol/L Seizures, coma, respiratory arrest, brainstem herniation and death. Table 2. Grading of hyponatremia. Hypernatremia…

…axillary nerve: sensation over the lateral part of the deltoid before and after the reduction , together with the distal pulse and sensation throughout the arm…

…increased respiratory rate and depth, increased sweating, and muscle fatigue. Although this is a subjective measure, it provides a fairly good estimate of the actual…

…progressive reduction of coronary blood flow sufficient to produce myocardial ischaemia and, when prolonged or severe, myocardial necrosis. It most commonly reflects atherothrombosis: disruption of…

…will experience severe chest pain due to the abrupt reduction of coronary blood flow. Acute coronary syndromes are subdivided into STE ACS and NSTE ACS …

…and bleeding complications than femoral access. In patients with acute coronary syndrome, randomized evidence has demonstrated lower rates of access site bleeding, surgical repair, and…

…to construct images with high spatial and temporal resolution. PET offers higher spatiotemporal quality, as compared with SPECT. Quantification of blood flow using PET Quantitative…

…consumption and thus infarct size. Beta blockers may limit or even reduce infarct size, which is generally attributed to its reduction of heart rate and…

…8. Document the ceiling of care and the decision on intubation early. Initial assessment Confirm that the presentation fits an exacerbation A COPD exacerbation is…

…data beyond perfusion imaging and ECG reaction. Coronary blood flow and coronary flow reserve (CFR) Coronary blood flow is the volume of blood flowing through…

…Black race, lower socioeconomic or uninsured status, a history of angina or diabetes, and consultation with relatives or physicians before contacting emergency services. These factors…

…C <1.4 mmol/L (<55 mg/dL), and at least a 50% reduction from baseline. For a patient who experiences a recurrent atherothrombotic event…

…and the apex is twisted counterclockwise. The twisting contraction is called circumferential shortening (Figure 2C). Figure 2A 2C. The orientation of myocardial muscle fibers results…

…return) of ST segment elevations. If the reperfusion is complete (after a total occlusion) the ST segment is normalized within one hour, and this confirms…

…utility is frequently limited by its inability to distinguish between muscle mass and various fat depots, or to identify the precise location of excess adiposity…

…Inter arm difference: a sequential systolic difference of 10 mmHg between the arms. Orthostatic hypotension: a fall of ≥20 mmHg in SBP and/or ≥10…

Psykiatri Akutsjukvård Lathundar Rapid summary Alcohol withdrawal occurs after an abrupt reduction or cessation of prolonged and heavy alcohol intake. The condition can develop despite…

…developing systemic hypersensitivity reaction that can cause life threatening compromise of the airway, breathing or circulation. Skin symptoms may be absent, and circulatory shock does…

…and the arm with the higher reading is used thereafter Two to three measurements one minute apart, taking the mean of the last two Orthostatic…

…hydroxide ions are generated at the negative pole of the battery and produce a liquefactive necrosis that can reach the septal cartilage within a few…

…crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces blood pressure while increasing catecholamine activity. Effects Primarily causes afterload reduction…

…perfusion of an upper or lower limb that causes tissue metabolic requirements to exceed available blood flow. The resulting ischaemia threatens skeletal muscle and peripheral…

…slope of diastolic depolarisation and produces a dose dependent reduction in sinus rate. Its principal therapeutic distinction from beta blockers is that it lowers heart…

…is somewhat arbitrary and there may be individual benefits of initiating treatment at lower blood pressure levels. KEY POINTS • The risk of cardiovascular disease increases…

…SVR) is rapid and may cause reflex sympathetic stimulation, including tachycardia. May therefore induce or worsen angina pectoris. The rapid reduction of afterload is desired…

…angiographic reduction of coronary obstruction. Intensive lipid lowering improves endothelial function, lowers circulating high sensitivity C reactive protein, reduces thrombogenicity, and favourably modifies inflammatory and…

…expiratory pressure and thereby increases ventilation and lowers the carbon dioxide. Pulmonary oedema calls for the former, a COPD exacerbation with carbon dioxide retention for…

…C) and other apoB containing lipoproteins in atherosclerotic cardiovascular disease (ASCVD). Atherosclerosis develops through the progressive deposition and retention of LDL C and other apoB…

…therefore focuses principally on ASCVD prevention and reduction of LDL C, non HDL C and apolipoprotein B. Causes and secondary contributors A search for secondary…

…5. Ask the patient to flex the head forward and swallow repeatedly , preferably with sips of water if swallowing is safe. Advance the tube in…

…products and sweets. An umbrella review incorporating observational studies and randomized trials reported associations between greater adherence to a Mediterranean diet and lower risks of…

…outcome Reported benefit of cessation Cardiovascular disease overall Substantial reduction in cardiovascular events and mortality Established coronary disease Approximately 36% lower risk of premature death…

…of a central reflex produces a stereotypic response: an initial increase in heart rate, followed by a drop in blood pressure, and finally a reduction…

…more effective than lower doses in preventing hospitalization. Abrupt withdrawal of treatment with an ACE inhibitor may lead to clinical deterioration and should be avoided…

…and delayed intensification of lipid lowering therapy may leave patients exposed to avoidable risk. Contemporary guidance therefore supports an early, intensive approach: treatment should begin…

…perforator of the left anterior descending artery was associated with lower five year survival than a more distal lesion. Revascularisation improves myocardial blood flow and…

…and A reduction of at least 50% from baseline . The treatment sequence is generally: High intensity statin therapy at the highest tolerated dose. Addition of…

…reduction of approximately 10% to 15% Possible effects on erythropoietin activity and erythropoiesis SGLT2 inhibition may also activate adenosine 5′ monophosphate activated protein kinase and…

…increased workload STATUS OF CORONARY ARTERY SETTING EFFECT ECG REACTION Normal coronary artery (no atherosclerosis) At rest Oxygen supply is adequate and ischemia cannot occur…

…risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive pulmonary disease, hay fever, or nasal polyps (increased risk of hypersensitivity…

…who report intolerance can ultimately take some form of statin therapy after systematic reassessment and rechallenge. The principal manifestation is statin associated muscle symptoms (SAMS)…

…the lower part of the target range. Paraquat poisoning — oxygen worsens the lung injury. Discuss with your national or regional poison control centre. An open…